Individual
WISAL IBRAHEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
522 KILBY AVE, SUFFOLK, VA 23434-5940
(860) 625-2339
Mailing address
522 KILBY AVE, SUFFOLK, VA 23434-5940
(860) 625-2339
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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